November 27, 2022

The murky waters of informed consent

Hi there,

Informed consent is a cornerstone of modern bioethics. It seems to have a flinty strength, but when put to the test, it begins to fracture and fissure. At least that’s what this week’s news from the Netherlands suggests to me.

The Royal Dutch Medical Association has recently taken a stand on circumcision of male babies. Its view is that the procedure is unethical because minors cannot consent to a non-therapeutic harm. Perhaps I am a bit dull, but how does this square with the Groningen Protocol, an agreement which allows Dutch doctors to euthanase male babies without their consent? Granted, there are differences, but it is hard to understand why it is unethical to circumcise babies but ethical to kill them. Are Dutch ethicists straining out the gnat and swallowing the camel?

This is not the only issue involving informed consent in the Netherlands this week. A newspaper has disclosed that a demented woman was euthanased back in March, even though, obviously, she could not give informed consent to the procedure. Granted, her advance directives anticipated the decision, but how could her doctor be sure that she still wanted to die? 

These cases raise troubling questions about the meaning of informed consent, at least for me. Any comments?  

Michael Cook